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Lookup NU author(s): Dr Mark Verrill
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
© Author(s) (or their employer(s)) 2026. Objective: To examine whether satisfaction with information provision and involvement in decision-making among people with breast cancer (BC) treated in English hospitals was associated with age and other patient characteristics. Design: Retrospective population-based cohort study, conducted as part of the National Audit of Primary Breast Cancer and the National Audit of Metastatic Breast Cancer. Setting: National Cancer Patient Experience Survey (CPES) responses linked to National Cancer Registration data for BC patients (stage 0–4) diagnosed between 2017 and 2021. Participants: 40 018 patients diagnosed with BC who responded to CPES between 2017 and 2021. Primary and secondary outcome measures: Responses to questions about overall experience of care, satisfaction with information provision, involvement in decision-making and clinical nurse specialist (CNS) contact were examined. The relationships between responses, personal, disease and clinical characteristics were analysed using multivariable Poisson regression. Results: 90% of patients rated their overall care as ≥8 out of 10 (0=very poor; 10=very good), decreasing to 82% for those aged <40 years (p<0.001). Adjusted analysis showed that stage 4 disease (incidence risk ratio (IRR) 1.19; CI 1.02 to 1.40; p<0.001), the highest deprivation (IRR 1.18; CI 1.07 to 1.30; p<0.001) and Asian (IRR 1.60; CI 1.42 to 1.82; p<0.001) or Black (IRR 1.53; CI 1.30 to 1.80; p<0.001) ethnicity were associated with a negative overall care experience. Satisfaction was high for information provision (85%) and involvement in decisions (81%), but lower among younger patients and those with advanced stage disease (both p<0.001). Fewer than 70% of patients aged <40 years felt sufficiently involved in decisions, compared with 81% >40 years (p<0.001). Patients with stage 4 disease were more likely to report dissatisfaction with involvement in decision-making (IRR 1.50: CI 1.36 to 2.67; p<0.001). Most patients (95%) had a named CNS, with 85% reporting ease of contact. Conclusion: Most patients reported high satisfaction with their BC care. Satisfaction was consistently lower among younger people and those with advanced disease; this finding might partly reflect more complex pathways but requires further exploration, ideally in partnership with patients to codesign solutions. Actionable remedial strategies are proposed.
Author(s): Blacker S, Withrow DR, Boyle JM, Wang L, Delon C, Medina J, Horgan K, Dodwell D, Verrill M, Lemanska A, Frampton AE, Cromwell DA
Publication type: Article
Publication status: Published
Journal: BMJ Open
Year: 2026
Volume: 16
Issue: 5
Online publication date: 12/05/2026
Acceptance date: 17/04/2026
Date deposited: 01/06/2026
ISSN (print): 2044-6055
ISSN (electronic): 2044-6055
Publisher: BMJ Publishing Group
URL: https://doi.org/10.1136/bmjopen-2025-110564
DOI: 10.1136/bmjopen-2025-110564
Data Access Statement: Data may be obtained from a third party and are not publicly available. This work uses data that have been provided by patients and collected by the NHS as part of their care and support. The data for England are collated, maintained and quality assured by the NDRS, which is part of NHS England. Data on English Cancer Registrations can be accessed via the NHS Digital Data Access request Service (DARS).
PubMed id: 42130004
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